26D2296612 CLIA NUMBER - ORTHO MISSOURI, LLC

Laboratory Demographics

  • CLIA Code: 26D2296612
  • Facility Name: ORTHO MISSOURI, LLC
  • Facility Address: 11330 OLIVE BLVD SUITE 150
    CREVE COEUR, MO
    ZIP 63141
  • Facility Phone: 314 782-1994
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL MALAK
  • NPI Number: 1447941067
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 26D2296612
LAB Type Physician Office
Facility Name ORTHO MISSOURI, LLC
Street 11330 OLIVE BLVD SUITE 150
City CREVE COEUR
State MO
ZIP 63141
Phone 314 782-1994
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director PAUL MALAK

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This page was last updated on: 9/29/2025